To ask if any Midwives here have experienced/dealt with a cord prolapse.

[Chorusforpoormortals]

and, could you explain/share your experiences, and maybe explain your procedures etc (especially regarding induction/breaking water,examinations) But I also have a few questions and any answers would be greatly appreciated.

Q1) Is it hard to diagnose due to fact it is rare?
Q2) How many internal examinations would you need to do to diagnose?
Q3) How would you reassure your 'patient'?
Q4) What is your role once 'patient' is in theatre/surrounded by obgynae peeps?

Also if anyone clicks and is not a midwife but has experienced this I am all ears for the sharing.

[WrenNatsworthy]

I'm not a midwife but I experienced cord prolapse. Why do you want to know?

[Chorusforpoormortals]

Good question, should have explained more, but am 6 wks post partum, had emergency section, process began due to midwife thinking I had prolapsed cord.

[ifyourehoppyandyouknowit]

Not directly my experience but a friend had cord prolapse during a homebirth, and sadly her son died. As far as I am aware it is very rare though, and she has gone on to have two more babies at home.

[steff13]

My eldest son had a prolapsed cord.

I am in the US, so I was attended by an OB, not a midwife, though. He (my son not the OB) was almost in the birth canal when it happened, so they gave me a dose of pitocin and he was born in what felt like a few seconds after that. I only pushed three times and he was out.

My doctor only required one internal exam to discover it; my son's heart rate dropped, and she came in to check me, and that's when she found it. She told me his heart rate was too low and he had to born right away, the nurse gave me pitocin, and there he was.

[Chorusforpoormortals]

I will try to explain further.

I was induced with dc2 -6wks ago- after having waters broken midwife believed I had prolapsed cord, I have 2 colleagues and 1 friend who lost their babies this way, so was terrified........midwife was wrong. Therefore was interested from midwives point of view/what to do in that situation, and also from people who have experienced it and what the processes were around their birth.

steff thats interesting,am glad you had a good outcome. Thanks, obviously you were further along than me, I was only 2-3cms due to induction.

[steff13]

Oh, yes, I was 8 or 9 cm, almost there, really. He was still blue when he was born and had to spend a couple of days on oxygen. :(

Why did the midwife think the cord was prolapsed? Did she think she saw it, or was the baby's heart rate low?

[Chorusforpoormortals]

My first was forceps with cord wrapped round neck badly _ hence forceps, she couldn't descend, NAVY she was, its really frightening isn't it, and that probably didn't help with all the kerfuffle going on with DC2

Midwife said (after she had broken waters ...3rd attempt... that she had to do internal to check that nothing had been forced into birth canal, she did check no 1 ( it was incredibly painful due to me not being dilated) she felt that she could feel something...... repeat to internal no 3(me on g&a trying to run away it was that painfull) upon which she declared twas DEFINITELY a cord prolapse. Twasnt.

[HauntedNoddyCar]

Was the mw being cautious and going with the safer option?

It's very difficult to answer without knowing the outcome and the course of action.

[Chorusforpoormortals]

Haunted could you explain what 'the safer option" would be?

outcome was emcs for something else entirely.

[steff13]

Were you not dilated at all when she broke your waters? Mine had to be broken with all three babies, but the doctor wouldn't do it until I was at least 4cm.

Did she check to see if the baby was in distress before she decided?

[Chorusforpoormortals]

steff

I am UK, and was being induced, process goes as follows,

go to induction ward, have pessary.

have checks to see if pessary has worked(in my case it did)

at 1-2cms (preferably 2) dilated be taken to delivery ward to have waters broken

No signs of distress from baby.

[missingmumxox]

Sounds like you want to make a case, very difficult with this one as although I am not a midwife my mum is and you don't need to see distress, just feel there is a prolapse and I don't mean feel in a wooly way.
The distress comes if the baby starts to push on the cord on the way out, you where only a few cams dilated, loads of time for that to happen.

Midwives like nurses are actually more at risk of our professional qualifications by omission, as in ignoring something we think is happening, rather than missing something which is happening.
Missing things is human, ignoring is deliberate, I hope this helps.

Congrats

[missingmumxox]

Btw I am a registered nurse

[HavannaSlife]

I was 4-5 cm when I had a cord prolapse, although with me it was obvious. I went to the toilet and could actually see the cord.

A mw held the cord back and tryed to make sure the baby wasnt pushing on it, I was dialating pretty quickly at this point. They catheterised me and filled up my bladder ( helps to relieve pressure on cord) and took me down to theater bsbies heart beat was dropping and he was born by emcs under ga within 20 mins of me finding the cord

[HicDraconis]

Had a patient with a cord prolapse at 4-5cm the other weekend. High head, not descending, waters broke -> cord through cervix.

A midwife pushed the cord back inside and held it there while she was wheeled into theatre - baby delivered by GA Caesarean section within 15 mins.

[Chorusforpoormortals]

missing I am dual qualified nurse, and I actually don't want to make a case, although I am planning on raising concerns with the department. But I am registered with the same professional body as the person who misdiagnosed this and have concerns.

Havanna What you describe is what I read is normal procedure, that is not what the midwife told me would happen, so I am thankful for you for telling your experience.

HicDraconis When you say cord through cervix, can you explain whether it was obvious in birth canal, and why did anyone touch it?

[HicDraconis]

The patient has her membranes ruptured with an amnihook and the cord fell through the cervix at the time. It was touched because it was pushed back through the cervix and held there to stop it being compressed during contractions. That's normal practice here.

GA Caesar is also normal practice here for a cord prolapse, it's one of the few times we don't have time to get a spinal in or top up an epidural.

[icanneverremember]

Hi, I think I had a cord prolapse but am not actually sure. It's the only sense I can make of my last birth.

I was about 4cm and suddenly the pain was intense (far beyond anything in my previous natural birth) I had the overwhelming urge to push. Babies heart rate kept dropping and not recovering. I then had a Cat 1 c-section under GA.

I can't remember if they examined me internally but they did the c-section primarily based on baby's distress.

[icanneverremember]

HicDraconis - interesting what you say about havingno time to top up an epidural - I have always wondered why I had a ga when I had just had and epidural placed!

[weebarra]

I'm not a MW but I was in hospital with threatened prem labour when the woman in the bed opposite had a cord prolapse. Middle of the night, her waters broke (she'd just been admitted so her mum was still with her). MW came, realised what had happened and pushed the cord up until they got her to theatre. She had a healthy baby boy, but just as well she was in hospital at the time. Must have been very scary for her.

[oohdaddypig]

I'm sorry you suffered this distress.

Given the potentially catastrophic results of not diagnosing this, I think I would be happy if my midwife erred on the side of caution. I appreciate you might not have wanted a section but the baby is here safe.

You can request a meeting to discuss your care post birth so you could ask the questions at that point to understand the decision making process? (I had such a meeting because of appalling midwife care, although thankfully DC was fine but I wasn't).

[imip]

I had a cord prolapse and my daughter died. It was obvious the cord was external to me. To be honest, I'd be grateful for the intervention on a suspicion, even if false...

The death of your baby is something you don't want to have to experience.

It was the fucking most terrible experience of my life, a true emergency. I watched my daughter dying on a scan... I too, was on hospital at the time.

I don't mean to sound trite or belittle your experience, but you baby is healthy. I have had subsequent traumatic births, 2 emcs, I no stranger to difficult births, I know nothing is as terrible as a cord prolapse (actually, holding your dead baby is the most heart-breaking thing ever).

I say this if you are planning to complain to the hospital. Pals is of course the way to go. However, I do warn you, I know women who have gone through pals to complain when their babies have died and you don't get a good outcome, just lip service.

You have a ga with a cord prolapse because it is a true emergency, catastrophic and baby needs immediate delivery.

Sorry to sound so negative but to have this experience and lost your child is such a sad experience beyond words. Counselling would be appropriate, but some end up holding their dead baby after the experience....

[imip]

Cross post daddy pig....

[imip]

So, AIBU is probably not the best place for this in my mind....

[ifyourehoppyandyouknowit]

. imip